The effects of lutein on optic nerve injury induced by ethambutol and isoniazid: an experimental study

Cutan Ocul Toxicol. 2019 Jun;38(2):136-140. doi: 10.1080/15569527.2018.1539010. Epub 2018 Nov 26.


Aim: Ethambutol and isoniazid are two major effective first line agents in tuberculosis treatment having some visual adverse effects. We aimed to determine the protective effects of lutein on oxidative optic neuropathy induced by ethambutol and isoniazid in an experimental model.

Material and method: Totally 24 albino Wistar male rats were assigned into 4 groups, with 6 rats in each group as follows: healthy controls (HC group), 50 mg/kg ethambutol +50 mg/kg isoniazid administered group (EI), 0.5 mg/kg lutein +50 mg/kg ethambutol +50 mg/kg isoniazid administered group (LEI-05) and only Lutein (0.5 mg/kg) (LUT group) administered group. From the blood samples and tissues obtained from the rats, Malondialdehyde (MDA), total glutathione (GSH), interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) levels were studied. Histopathological evaluations were performed at the end of the study.

Results: Serum and tissue IL-1β, TNF-α and MDA levels were the highest in EI group which were significantly lower in lutein administered group. On the other hand, serum and tissue total GSH levels were the lowest in EI group which were significantly higher in Lutein administered group. In histopathological evaluations, there were significant differences between EI group and all other three groups with edema and hemorrhage in connective tissue covering optic nerve, dilated and congested capillary, decrease in astrocytes and oligodendrocytes.

Conclusion: Isoniazid and ethambutol induced toxic optic neuropathy although not common, may have some potential devastating effects on vision. Lutein is determined as an effective agent in prevention of isoniazid and ethambutol induced toxic optic neuropathy.

Keywords: Lutein; ethambutol; isoniazid; optic neuropathy.

MeSH terms

  • Animals
  • Ethambutol
  • Eye / drug effects
  • Eye / metabolism
  • Eye / pathology
  • Glutathione / metabolism
  • Interleukin-1beta / metabolism
  • Isoniazid
  • Lutein / therapeutic use*
  • Male
  • Malondialdehyde / metabolism
  • Optic Nerve Diseases / chemically induced
  • Optic Nerve Diseases / drug therapy*
  • Optic Nerve Diseases / metabolism
  • Optic Nerve Diseases / pathology
  • Rats, Wistar
  • Tumor Necrosis Factor-alpha / metabolism


  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha
  • Malondialdehyde
  • Ethambutol
  • Glutathione
  • Isoniazid
  • Lutein